Individual
STACEY R SPROULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
364 SE 8TH AVE STE 108A, HILLSBORO, OR 97123-4253
(503) 494-8417
(503) 494-4455
Mailing address
364 SE 8TH AVE STE 108A, HILLSBORO, OR 97123-4253
(503) 494-8417
(503) 494-4455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN9165986
FL
363LA2200X
Adult Health Nurse Practitioner
AP61272607
WA
363LG0600X
Gerontology Nurse Practitioner
Primary
10018726
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528412624
—
WA
Enumeration date
04/15/2016
Last updated
01/31/2024
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